Confronting Organized Insurance-Fraud Schemes and Sham Claims
Avoiding Payment of Sham Claims, Tools to Deter and Recover from Scheme Leaders, Seeking Criminal Prosecution
Insurance fraudsters now have advanced digital tools to make it more difficult in distinguishing the fraudulent claim from the valid one. Particularly concerning, perpetrators of fraud can now manipulate medical records, including x-rays and pet-scans, photographs and video, and metadata to produce convincing forgeries that are difficult to spot and prove.
Insurance fraud will usually focus on recovering high-value claims, such as from business interruption (data theft), jewelry theft, fire and water damage, inland marine, and other specialized property losses. But the “scams” are perennial: inventory swapping; submitting claims for injuries or damage that never occurred; staging accidents; forgery, involving unwitting third parties, and more.
To deter and thwart these increasingly complex and sophisticated deceptions that may cross multiple industries and involve different kinds of coverage, insurers and their counsel need practical, decisive, and effective weapons. At the same time, they must balance the need to avoid claims of bad faith, making false accusations, and comply with insurance regulations. How much information to provide prosecutors is always a challenging question. State immunity laws do not always cover allegations of insurance fraud.
Linda Perkins serves on a panel of insurance fraud professionals discussing proactive steps to identify fraud early on and then prevent payment of the falsified claim, and if payment has occurred, how to judiciously but vigorously recover payment from the masterminds. This CLE webinar will guide attorneys representing insurance companies in spotting and unraveling increasingly complex and organized fraud.
The panel will review these and other significant matters:
- Red flags signaling fraud
- Finding the right experts to assist with a sophisticated fraud examination
- Using the right technology and the latest computer software to uncover "deep fakes"
- How to build the fraud case from the beginning to ensure the best result
- Dealing with immunity laws and responses from those being investigated
- Pre-trial remedies to preserve assets